A Survey of Competency Based Recruitment and Selection ...

A SURVEY OF COMPETENCY BASED RECRUITMENT AND

SELECTION PRACTICES ADOPTED BY REGISTERED

HOSPITALS IN NAIROBI

DORIS MWANGI

A RESEARCH PROPOSAL SUBMITTED IN PARTIAL FULFILMENT OF THE

REQUIREMENTS FOR THE AWARD OF THE DEGREE OF MASTERS OF

BUSINESS ADMINISTRATION (MBA), SCHOOL OF BUSINESS, UNIVERSITY

OF NAIROBI

NOVEMBER 2013

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DECLARATION

This research project is my original work and has not been presented for a degree award to

any other university.

Signed: ………………….. Date: ……………………

DORIS MWANGI

This research project has been submitted for examination with my approval as University

Supervisor

Signed: ………………….. Date: ……………………

PROF K’OBONYO

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DEDICATION

I would like to dedicate this research project paper to my father, who has instilled in me the

love of knowledge and continuous learning, all the way from kindergarten stage up until

my current level. I will always treasure his support and belief in my capabilities.

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ACKNOWLEDGEMENT

I would like to acknowledge the University of Nairobi as a whole for giving me the

opportunity to pursue my higher education at an advanced level. In particular, the

mentorship of my supervisor greatly assisted me in my professional skill set. Thank you

all.

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TABLE OF CONTENTS

Declaration ....................................................................................................................... ii

Dedication ....................................................................................................................... iii

Acknowledgement ........................................................................................................... iv

List of Tables ................................................................................................................. viii

List of Figures .................................................................................................................. ix

List of Abbreviations and Acronyms ..................................................................................x

Abstract ........................................................................................................................... xi

CHAPTER ONE

INTRODUCTION ...........................................................................................................1

1.1 Background of the study ..........................................................................................1

1.1.1 The Concept of Competency ....................................................................................3

1.1.2 Recruitment and Selection .......................................................................................5

1.1.3 Competency Based Recruitment and Selection .........................................................6

1.1.4 Kenya HealthCare System .......................................................................................7

1.1.5 Hospitals in Nairobi County .....................................................................................9

1.2 Research Problem .................................................................................................. 10

1.3 Research Objective ................................................................................................ 13

1.4 Value of the Study ................................................................................................. 13

CHAPTER TWO

LITERATURE REVIEW .............................................................................................. 15

2.1 Meaning and Importance of Competencies ............................................................. 15

2.2 Competency Framework ........................................................................................ 17

2.3 Recruitment and Selection Practices....................................................................... 19

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2.4 Competencies and changing perspectives on HRM ................................................ 21

2.5 An integrated approach to HRM – the role of competencies ................................... 23

2.6 Methodologies for developing competencies .......................................................... 24

2.6 Criticisms on Competency Frameworks ................................................................. 28

CHAPTER THREE

RESEARCH METHODOLOGY .................................................................................. 31

3.1 Introduction ........................................................................................................... 31

3.1 Research Design .................................................................................................... 31

3.2 Target Population .................................................................................................. 31

3.3 Sampling Design.................................................................................................... 31

3.4 Data Collection ...................................................................................................... 32

3.5 Data Analysis ........................................................................................................ 32

CHAPTER FOUR

FINDINGS, ANALYSIS AND INTERPRETATION ................................................... 33

4.1 Introduction ........................................................................................................... 33

4.2 Demographic Data ................................................................................................. 33

4.3 Factors considered in recruiting new staff .............................................................. 35

4.4 Interpersonal relations ............................................................................................ 36

4.5 Self-awareness/ confidence .................................................................................... 37

4.6 Analytical thinking ................................................................................................ 38

4.7 Adaptability/flexibility ........................................................................................... 39

4.8 Observation skills .................................................................................................. 40

4.9 Sense of mission .................................................................................................... 40

4.10 Communication skills ............................................................................................ 41

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4.11 Motivation ............................................................................................................. 42

4.12 Planning and organizing work ................................................................................ 43

4.13 Teamwork ............................................................................................................. 44

CHAPTER FIVE

SUMMARY, CONCLUSIONS AND RECOMMENDATIONS .................................. 45

5.1 Introduction ........................................................................................................... 45

5.2 Summary of findings ............................................................................................. 45

5.3 Conclusions ........................................................................................................... 49

5.4 Recommendations......................................................................................................50

5.5 Suggestions for further studies ............................................................................... 51

REFERENCES .............................................................................................................. 53

APPENDICES ................................................................................................................ 56

Appendix I: Questionnaire ............................................................................................... 56

Appendix II: List of Hospitals .......................................................................................... 60

Appendix III: List of Sampled Hospitals .......................................................................... 62

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LIST OF TABLES

Table 4.1: Distribution of respondents by gender ............................................................. 33

Table 4.2: The extent to which various factors are considered in recruiting new staff ....... 35

Table 4.3: Mean and standard deviation for the measures interpersonal relations.............. 36

Table 4.4: Mean score and standard deviation for measure of self-awareness/ confidence 37

Table 4.5: Mean and standard deviaitions for the measure of analytical thinking .............. 38

Table 4.6: Mean scores and standard deviations for measures of adaptability/flexibility ... 39

Table 4.7: Mean scores and standard deviations for measures of observation skills .......... 40

Table 4.8: Mean scores and standard deviations for measures of sense of mission ............ 40

Table 4.9: Mean scores and standard deviations for measures of communication skills .... 41

Table 4.10: Mean scores and standard deviations for measures of motivation ................... 42

Table 4.11: Mean scores and standard deviations for measures of planning and organizing work ................................................................................................................................ 43

Table 4.12: Mean scores and standard deviations for measures of teamwork .................... 44

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LIST OF FIGURES

Figure 4.1: Distribution of respondents by age bracket ..................................................... 34

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LIST OF ABBREVIATIONS AND ACRONYMS

CBHRM: Competency based human resource management

CIPD: Chartered Institute of Personnel and Development

HRH: Human Resource for Health

HRM: Human Resource Management

WHO: World Health Organisation

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ABSTRACT

The current Human Resource for Health (HRH) challenges include inadequate and inequitable distribution of health workers; high turnover; weak Human Resource Development, planning, management and Human Resource for Health information systems and the performance management framework at all level. Most organizations have little insight into the recruiter skills that have the greatest impact on quality of hire and time to productivity. As a result, recruiter training is often unfocused and misaligned with the drivers of new hire quality. The research objective was to determine the competency based recruitment and selection practices by registered hospitals in Kenya. This study was descriptive in nature. This design is preferred because it permits comparative analysis. The researcher targeted all the sixty (60) registerd hospitals in Nairobi where a sample size of forty hospitals was selected.Primary data was collected. This was used to address competency based recruitment and selection practices. Data collected from respondents was both quantitative and qualitative in nature. Quantitative data will be analyzed using the descriptive statistics such as mean scores and standard deviations. The findings were then presented using tables, pie charts, and bar graphs for easier interpretation. On the other hand, qualitative data was analyzed using content analysis. The qualitative information was used to interpret or better understand quantitative findings. It can be concluded that the results from the findings of the questionaire demonstrated that competency based recruitment procedures were paramount in selecting new hires. The respondents recognized that competency based recruitment procedures can work hand in hand with traditional recruitment and selection procedures. The competency based approach to recruitment and selection was considered important in the recruitment and selection stage of Human Resource Management processes.Based on the findings, it is recommended that, the need to develop and implement a communication strategy to support the Human Resource Departments. It is also important to build awareness is an important starting point. HR staff and hospital management should attend workshops, classes, or conferences on competency modelling or invite external consultants.

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CHAPTER ONE

INTRODUCTION

1.1 Background of the study

Smit and Cronje (1982) claim that it is people who give life to an organisation and that

they can be regarded as an organisation’s most important resources. Covey (1997) agrees,

stating that people attain the highest value in an organisation, because they are the

programmers-who produce everything else at the personal, interpersonal, managerial and

organisational levels. Grier (1999) explains that the economic turbulence, globalisation,

technology, changing demographics, and differences in workforce values have created

almost unprecedented environmental uncertainty. In these conditions human resources is

one of the few factors over which organisations have a measure of control, thus reinforcing

human resources as a distinctive factor for competitive advantage. This automatically

implies that other factors are conditional for entry into competition. Johnson and Scholes

(2002) state that the possession of resources, including people, does not guarantee strategic

success. However, the way these resources are deployed, managed, controlled and, in the

case of people, motivated to create competence in those activities and business processes

needed to achieve competitive advantage, differentiate the mediocre from the market

leaders.

According to Mullins (2010), if the HRM function is to remain effective, there must be

consistently good levels of teamwork, plus ongoing co-operation and consultation between

line managers and the HR manager.’’ This is most definitely the case in recruitment and

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selection as specialist HR managers (or even external consultants) can be an important

repository of up-to-date knowledge and skills. In a dynamic environment, health managers

need to combine leadership, en entrepreneurial and administrative skills to meet the

challenges that the changing socio-political, economic and technological landscape

presents, as well as the expectations of patients, health professionals, politicians and the

public. Without good management we will be unable to improve efficiency, effectiveness

and responsiveness in the delivery of health services or upscale to achieve health goals

(Travis et al.2004).

Hospitals are important vehicles for the delivery of health care, and managers of these

institutions are to a large extent responsible for operationalizing the visions and objectives

that policy-makers have for the health and wellbeing of a nation (Lehman et.al.

2002).Determining and assessing competencies is a vital precursor to improving

professional development and the alignment of individual development with the need of an

organization or profession (Calhoun et.al. 2004). The competency-based approach to

professional development is well accepted in higher education (Westera 2001), and in

human resource management literature where it is regarded as a critical part of the overall

management development process, as it allows one to identify the gaps between current

skills and the skills required (Brown 2002,Jinabhai 2005) . Appropriate programmes based

on the personal needs and experiences of health managers can then be put in place to train

managers to provide leadership and to ensure a sustainable improvement in the work

context of health workers, and hence on the quality of care and health of the communities

their organizations serve (Gough and Price 2004).

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1.1.1 The Concept of Competency

The definitions of competency are varied and include the ability of a person to perform a

job (Woodruffe, 1993); skills that are developed in a pattern (Bradley & Huseman, 2003);

a behavior or series of actions that can be demonstrated, observed, and assessed (Manley &

Garbett, 2000). The concept of competence or competency dominated the management

strategy literature of the 1990s, which emphasized core competence as a key organizational

resource that could be exploited to gain competitive advantage (Campbell and Sommers

Luchs,1997; Mitrani et al., 1992; Nadler and Tushman, 1999). Hamel and Prahalad defined

core competence as ‘’the collective learning in the organisation, especially how to co-

ordinate diverse production skills and integrate multiple streams of technologies’’

(Prahalad and Hamel, 1990).

From the perspective of a resource-based theory of the firm, sustained competitive

advantage is seen as deriving from a firm’s internal resources .If these can add value, are

unique or rare, are difficult for competitors to imitate and are non-substitutable (Cappelli

and Crocker-Hefter, 1996; Ellestro1992; Foss and Knudsen, 1996). The virtue of the core

competence approach is that it ‘recognises the complex interaction of people, skills and

technologies that drives firm performance and addresses the importance of learning and

path dependency in its evolution’ (Scarborough, 1998). Snyder and Ebeling (1992) refer to

competence in a functional sense, but use ‘competencies’ in the plural. Some authors

consistently use ‘competency’ when referring to occupational competence (Boam and

Sparrow, 1992; Mitrani et al.,1992; Smith, 1993) or treat the two as synonymous (Brown,

1993, 1994). Hartle argues that competency as a characteristic of an individual that has

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been shown to drive superior job performance (1995) includes both visible competencies

of knowledge and skills and underlying elements of competencies like traits and motives.

Elkin (1990) associates competence with micro-level job performance and competencies

with higher management attributes and, in defining managerial competencies for the

future, Cockerill (1989) combines output competences, like presentation skills, with inputs

like self-confidence. The difficulty of using competence as an overarching term as well as

a specific one is demonstrated by the apparently tautological definition provided by

Dooley et al(2004).Competency-based behavioural anchors are defined as performance

capabilities needed to demonstrate knowledge, skill and ability (competency) acquisition.

Mangham (1986) noted that competence may relate to personal models, outcome models

or education and training models, as well as to the standards approach in which

benchmarking criteria are used. Mansfield (2004) similarly contrasts three different usages

of competence: outcomes (vocational standards describing what people need to be able to

do in employment); tasks that people do (describing what currently happens); and personal

traits or characteristics (describing what people are like). Weinert (2001) lists nine

different ways in which competence has been defined or interpreted: general cognitive

ability; specialized cognitive skills; competence performance model; modified

competence-performance model; objective and subjective self-concepts; motivated action

tendencies; action competence; key competencies; meta-competencies.

Since competences are centred on the individual, they are viewed as independent of the

social and task-specific context in which performance occurs, yet skill level is a

characteristic not only of a person but also of a context. People do not have competences

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independent of context (Fischer et al, 1993). Constructivist and interpretative approaches

derived from phenomenology view competence as a function of the context in which it is

applied, where worker and work form one entity through lived experience of work

(Sandberg, 2000). Competence is constituted by the meaning that the work has for the

worker in their experience (Stoof et al., 2002; Velde, 1999). Dreyfus and Dreyfus (1986),

who used an interpretative approach to investigate competence among pilots and others,

found that attributes used in accomplishing work are bound to the work context regardless

of the level of competence attained and that in the work situation individuals acquire

situational or context-dependent knowledge and skills. Other interpretative studies, with

nurses (Benner, 1984) and police officers (Fielding, 1988a, 1988b), have equally

demonstrated that attributes acquire context-dependency through individuals’ experience

of work.

1.1.2 Recruitment and Selection

Labour market shortages and recruitment difficulties have led to a more competitive

recruitment market in the last decade. Lievens, van Dam and Anderson (2002) asserted that

the war for talent meant that the emphasis in organisations moved from the selection to the

attraction of employees. Recruitment “includes those practices and activities carried out by

the organisation with the primary purpose of identifying and attracting potential

employees” (Breaugh & Starke, 2000) and has long been regarded as an important part of

human resource management as it performs the essential function of drawing an important

resource - human capital- into the organisation (Barber, 1998). The strategic significance

of recruitment is often reported in the literature (Boxall and Purcell, 2003), the emphasis

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being upon the need to attract and retain high quality people in order to gain a competitive

advantage, as is consistent with the resource-based view (Barney1991; Barney and Wright,

1998; Wright and McMahon, 1992).

Recruitment and selection play a pivotal role in service delivery. If utilised efficiently it

can be cost effective in more than one way. From a managers point of view the objective is

to get the maximum return on investment from human capital. Investments, such as

salaries, cost of recruitment, training, fringe benefits, are expected to be returned in the

form of profits or some sort of increase in the bottom-line. Hammersak (2002) explained

that star performers usually return three to seven times their salary’s worth in productivity.

If the right person is appointed, training cost will be minimised, breaks in delivery

decreased, and production or service increased, putting the organisation in a position of

achieving its key performance objectives of: dependability, cost, speed and quality (Slack,

Chamber and Johnson, 2001). The wrong appointment implies extended training, thus no

service or production, or incorrect service or production, over a longer period, and higher

cost to the organisation.

1.1.3 Competency Based Recruitment and Selection

Sparrow (1995) has observed that the competency literature includes a huge range of

claimed benefits specific to HR processes in organisations. Included are improved

recruitment and selection practices through a focus on required competencies.

Hiring competent people is of paramount importance and this is dependent on effective

recruitment and selection procedures which aim to select the right individuals and reject

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the wrong ones .(Hacker 1997) Costs incurred can include low productivity, potential loss

of clients ,training costs ,advertising costs, recruitment fees and redundancy packages

.(Smith and Granes 2002)

One of the earliest ,management writers FW Taylor(1911) bemoaned the way in which

individuals were selected based on’ who you knew’ or who was first in the queue. Taylor

introduced the idea that people should be selected for their particular skills and abilities

which should be tested prior to the selection decision. Traditional recruitment and selection

has been viewed as a process by which the organization tries to accurately match the

individual to the job and can be compared to a jigsaw puzzle. (Stephen Bach 1990) The

introduction of a competency based recruitment process can help to improve workplace

performance by allowing managers to assess candidates more objectively (Farnham 2000)

1.1.4 Kenya HealthCare System

The health sector comprises the public system, with major players including the MOH and

parastatal organisations, and the private sector, which includes private, for-profit, NGO,

and FBO facilities. Health services are provided through a network of over 4,700 health

facilities countrywide, with the public sector system accounting for about 51 percent of

these facilities.

Kenya’s health care delivery system, which is charged with meeting health policy

objectives, is organised around the Ministry of Health (MoH). The Ministry of Health

headed by the Minister is charged with the responsibility of setting policies, coordinating

the activities of Non-Governmental Organisations (NGOs), and managing, monitoring and

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evaluating policy implementation (Owino 1997). Kenya’s Ministry of Health is the largest

provider of health care (curative, preventive and promotive) and undertakes environmental

protection and pollution surveillance (Odada and Odhiambo 1989). In general, the Ministry

of Health is involved in six-health related programmes, namely promotional and

preventive health care, family planning and population control, environmental protection

and programme supervision, special programmes (such as disease control projects), and

research. (Odada and Odhiambo 1989)

The public health system consists of the following levels of health facilities: national

referral hospitals, provincial general hospitals, district hospitals, health centres, and

dispensaries. National referral hospitals are at the apex of the health care system, providing

sophisticated diagnostic, therapeutic, and rehabilitative services. The two national referral

hospitals are Kenyatta National Hospital in Nairobi and Moi Referral and Teaching

Hospital in Eldoret. The equivalent private referral hospitals are Nairobi Hospital and Aga

Khan Hospital in Nairobi.

Provincial hospitals act as referral hospitals to their district hospitals. They also provide

very specialized care. The provincial level acts as an intermediary between the national

central level and the districts. They oversee the implementation of health policy at the

district level, maintain quality standards, and coordinate and control all district health

activities. Similar private hospitals at the provincial level include Aga Khan Hospitals in

Kisumu and Mombasa. District hospitals concentrate on the delivery of health care

services and generate their own expenditure plans and budget requirements based on

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guidelines from headquarters through the provinces. (Dr. Richard Muga, Dr. Paul Kizito,

Mr. Michael Mbayah, Dr. Terry Gakuruh, 2005).

The network of health centres provides many of the ambulatory health services. Health

centres generally offer preventive and curative services, mostly adapted to local needs.

Dispensaries are meant to be the system’s first line of contact with patients, but in some

areas, health centres or even hospitals are effectively the first points of contact.

Dispensaries provide wider coverage for preventive health measures, which is a primary

goal of the health policy.

The government health service is supplemented by privately owned and operated hospitals

and clinics and faith-based organisations’ hospitals and clinics, which together provide

between 30 and 40 percent of the hospital beds in Kenya. (Dr. Richard Muga, Dr. Paul

Kizito, Mr. Michael Mbayah, Dr. Terry Gakuruh,2005) This study, however, will be

concentrated on registered hospitals in Nairobi with the view of finding(s) on the

competency based procedures they utilize for recruitment.

1.1.5 Hospitals in Nairobi County

Hospitals in Nairobi are classified under various levels with the highest health institution

being the referral hospital, followed by the general hospital then followed by the health

centre then finally the dispensary in descending order. Clinics are normally the smallest

health facilities in Kenya and can be mobile or fixed premise in nature. Nairobi county

hospitals spread 1 referral hospital, 60 hospitals, 61 health centres and 395 sub health

centres and dispensaries. Most of the hospitals in Nairobi have recognized modern

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diagnostic and treatment center throughout East Africa. The hospitals have a state-of-the-

art emergency center which provides medical care that is in keeping with international

standards. Apart from the emergency center, the hospitals also have facilities such as a

highly sophisticated and comprehensive diagnostic laboratory, a physical medicine center,

ambulatory surgery and medical advisory services. A typical one is the Nairobi Hospital

which runs clinics throughout different days and times of the week to meet the various

medical needs of the patients. These clinics are Family Health Clinic, Child Welfare

Clinic, Antenatal Clinic, Senior Citizens clinic, Chemotherapy Center, Diabetes Clinic,

Travel and Immunization Clinic, Breast Health Clinic and Chest Clinic. The address for

this hospital is Argwings Kodhek Road.

1.2 Research Problem

The current Human Resource for Health (HRH) challenges include inadequate and

inequitable distribution of health workers; high turnover; weak Human Resource

Development, planning, management and Human Resource for Health information systems

and the performance management framework at all level (AHWO,2009). Most

organizations have little insight into the recruiter skills that have the greatest impact on

quality of hire and time to productivity. As a result, recruiter training is often unfocused

and misaligned with the drivers of new hire quality (Recruiting Roundtable, 2008

Corporate Executive Board). Progress in achieving goals in Human Resource Recruitment

strategies relies on increasing resources and most importantly on managers who are able to

lead and manage teams at all levels of the health system to transform HR Strategies, plans

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and recommendations into a comprehensive, harmonized approach that is effectively

implemented and sustained (Amref, 2009).

The health sector is labour-intensive and dependant on its workforce for the precise

application of the knowledge and technical skills in the provision of health care services.

Human Resources (HR) in the sector is both a strategic capital and a critical resource for

the performance of the health system. The overall goal is for employment of optimal levels

of human resources and the development of capacity in line with the health needs of the

population (AHWO, 2009). Over the years, organizations and industry have utilized

diverse approaches to select employees. With a dire need for transformation so as to match

environmental dynamics, the trend to use competency-based approaches for assessment,

and development of workers has experienced a significant emergence. Organizations have

turned their focus from skills acquisition and assessment to the competency modeling

process for determining the needs of business and employers. Competency based human

resource management (CBHRM) utilizes the concept of competency analysis to inform and

improve the processes of recruitment and selection as well as performance management

(Armstrong, 2005). Today’s knowledge based operating environment is subject to

accelerating changes, which require efficient and effective recruiting methods to satisfy the

demand of organizations in addition to getting the right employees into the right jobs

(Lindgren et al, 2004). In response to these demands, it’s imperative to have a model that

integrates competencies of persons into the recruitment process.

Currently there are several competency models available in the market which can be used

for enhancing effectiveness of the HR function. These models have been developed by

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functional experts, academicians and consultants basically to educate people and help them

develop these competencies. For example Ulrich Dave has come out with a Human

resource competency model. The need for more research into the construction of

personality in addition to determinants and consequences of behavior is doubtlessly a

perpetual concern of scholars. The predictive utility of employee assessment is enhanced

when job type and personality constructs are matched, either based on the findings of

previous research, rational analysis, or a thorough personality oriented job analysis

(Raymark, Schmit, & Guion, 1997). Each year, about two hundred doctors and six hundred

nurses exit the service due to poor remuneration and working environment amongst others.

Resignations constitute the highest percentile of attrition. Improving the disciplinary

control is still a challenge due to the poor leadership and management standards especially

given that supervisors are themselves guilty of flaunting ethical standards and engaging in

unprofessional conduct. Absenteeism is quite rampant and occasioned by dual practice

among doctors, part-time employment of health workers on locum basis in private facilities

and unauthorised private practice (African Health Workforce Observatory, 2009)

Accumulated research in academic and applied settings supports the assertion that

personality can be reliably measured and is a valid predictor of job performance for most

tasks. This research has demonstrated that despite the great value they portend,

competency based assessment are yet to be meaningfully exploited within Kenyan

recruitment settings. Therefore given this trend it would be important to conduct a study to

determine the competency based procedures by registered hospitals in Nairobi. This is

critical because each organization requires a tailored & standardized competency

framework and previous studies such as BMC Health Services (Australia) and Amref

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(2009 have indicated the need for more research on the use of competencies especially in

the recruitment and selection process. However, it is clear that there is also considerable

variation in the understanding and application of the competency approach in health

promotion and related fields. Despite these, past studies have inadequately addressed

competency based recruitment and selection practices. Beside this, no any research on

recruitment and selection is known to have been done in Nairobi. This study therefore

sought to fill the existing gap by investigating the competency based recruitment and

selection practices for hospitals in Nairobi County.

1.3 Research Objective

The research objective was to determine the competency based recruitment and selection

practices by registered hospitals in Kenya.

1.4 Value of the Study

This research study will have various beneficiaries. The information provided can prepare

organizations to face long term strategies and specifically Human Resource recruitment

problems that span entire organizations and command attention of senior managers.

Human Resource professionals mastering competencies can also use the findings of this

study in shaping organizations to deliver productivity gain, increased retention and

improved organizational needs. Human Resource leaders using competencies are able to

track critical organizational challenges relevant to recruitment. Architects of Human

Resource Solutions can use the findings of this paper to transform organizations into

admired centres of excellence. Furthermore, continuing Human Resource students can

utilize this research paper for further insight and research on competencies and

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recruitment. Overall, competencies have been shown to provide a useful base for health

promotion training, academic preparation, and continuing professional develop.

The study will also be useful to the relevant government authority which rely on it in

development of policy framework for recruitment and selection of personnel in hospital

who are competent for the field they are mandated.

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CHAPTER TWO

LITERATURE REVIEW

2.1 Meaning and Importance of Competencies

Competency refers to skills or knowledge that leads to superior performance. These are

formed through an individual/organization’s knowledge, skills and abilities and provide a

framework for distinguishing between poor performances through to exceptional

performance. Competencies can apply at organizational, individual, team, and occupational

and functional levels. Competencies are individual abilities or characteristics that are key

to effectiveness in work. Competencies are the characteristics of a manager that lead to the

demonstration of skills and abilities, which result in effective performance within an

organizational area. Competencies have been increasingly used in education and the labor

market since the 1970s, when psychologists suggested the importance of testing for

competency rather than intelligence. As a relatively new concept it has engaged the interest

of academics and practitioners, particularly of those working in professions that have been

affected by technological, organizational or cultural changes. It is accepted that a

competencies approach can be helpful to describe sets of tasks, performances, skills and

abilities in real-life work situations (Meresman et al.2004).

Amatetti and Carnes (2009) articulated a framework where they defined competencies as a

set of related knowledge, skills, attitudes/attributes that are necessary to successfully

perform job duties and responsibilities. Knowledge, in this context, refers to what someone

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knows (facts, research and principles) and it may be acquired and applied in a variety of

settings, for example, through education and training or in the workplace. Skills are

described as what someone does and the specific proficiencies and techniques that enable

individuals to deliver effective services. Attitudes and attributes are defined as a person’s

perspective and personal qualities which include empathy and support, and attributes are

personal characteristics such as respect and recognition. These definitions highlight that

competencies refer not only to knowledge, but also to skills and attitudes. Core

competency development is widely used in workforce initiatives to identify the essential

elements for effective performance. Characteristics of core competencies are that they

provide a set of unifying principles, are pervasive in all strategies and that they are rare

and/or difficult to imitate (Prahalad and Hamel, 1990). Efforts to expand capacity to meet

the needs of the population are reported as requiring a workforce with sufficient

competencies to address the challenges faced (Ameretti and Cairnes, 2009). Competencies

which are specific to health promotion, therefore, need to be based on the core concepts,

principles and actions of health promotion as articulated in the World Health Organisation

(WHO) declarations.

Core competencies need to be regularly reviewed and updated in response to changes in

contemporary practice, new health needs and policy contexts. In addition, competencies

may also be used as the basis for the development of standards and quality assurance

mechanism, such as the certification of individual practitioners and accreditation of

academic professional preparation programmes (Taub et al., 2009).

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2.2 Competency Framework

Competency frameworks are a method of describing the underpinning values that shape

and define the culture of an organization. They also provide clear focus to support the

development of staff in order to deliver the best possible services. There are a number of

competencies in each framework. Underneath each is a general description of the

competency, followed by a list of attitudes/behaviours that would indicate competence in

the relevant area. The process of competency development is a lifelong series of doing and

reflecting. As competencies apply to careers as well as jobs, lifelong competency

development is linked with personal development as a management concept. And it

requires a special environment, where the rules are necessary in order to introduce novices,

but people at a more advanced level of competency will systematically break the rules if

the situations require it. This environment is synonymously described using terms such as

learning organization, knowledge creation, self-organizing and empowerment. Within a

specific organization or professional community, professional competency, is frequently

valued. They are usually the same competencies that must be demonstrated in a job

interview. But today there is another way of looking at it: that there are general areas of

occupational competency required to retain a post, or earn a promotion. For all

organizations and communities there is a set of primary tasks that competent people have

to contribute to all the time (Amatetti and Carnes, 2009).

A universal framework for examining health problems and for suggesting courses of action

needed for their solution was proposed and as these ideas were comprehensive they had a

unifying effect, bringing together into one common front: health professionals, health

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services, the scientific community, educational system, governments (municipal,

provincial, federal), business sector, trade unions, voluntary organisations and the

Canadian people. The Lalonde report was very influential internationally and it has been

claimed, laid the foundations for the development of the Ottawa Charter, which was

published by the WHO in 1986. Health promotion is viewed as not only the responsibility

of the health sector, but goes beyond healthy lifestyles to well-being. Health promotion,

therefore, represents a comprehensive social and political process, which not only

embraces actions directed at strengthening the skills and capabilities of individuals, but

also action directed towards changing social, environmental and economic conditions so as

to alleviate their impact on public and individual health (WHO, 1986).

Five key action areas are identified for improving the health of populations (WHO, 1986;

Kicksusch, 2003). These actions include building a healthy public policy, creating

supportive environments by embracing the socio-ecological approach to health where the

societies in which people live and work must be able to support healthy choices in order

for people to achieve health, strengthening community action by empowering and enabling

communities to improve their health by becoming involved in setting priorities, making

decisions, planning strategies and implementing them to achieve better health ,developing

personal skills and enhancing life skills and finally by reorienting the health services

through a shared responsibility by individuals, community groups, health professionals,

health service institutions and governments.

19

2.3 Recruitment and Selection Practices

Recruitment and selection practices form a core part of the central activities underlying

human resource management: namely, the acquisition, development and reward of

workers. It frequently forms an important part of the work of human resource managers –

or designated specialists within work organizations. However, and importantly,

recruitment and selection practices are often for good reason taken by non-specialists, by

the line managers. There is, therefore, an important sense in which it is the responsibility

of all managers, and where human resource departments exist, it may be that HR managers

play more of a supporting advisory role to those people who will supervise or in other

ways work with the new employee.

As Mullins (2010) notes: ‘If the HRM function is to remain effective, there must be

consistently good levels of teamwork, plus ongoing co-operation and consultation between

line managers and the HR manager.’ This is most definitely the case in recruitment and

selection as specialist HR managers (or even external consultants) can be an important

repository of up-to-date knowledge and skills, for example on the important legal

dimensions of this area. Recruitment and selection is often presented as a planned rational

activity, comprising certain sequentially-linked phases within a process of employee

resourcing, which itself may be located within a wider HR management strategy (Bratton

and Gold 2007).

According to Mullins (2010), some of the common benchmark competency-based

practices in Recruitment and Selection include:

20

Notices of job requirements - A template is developed to define how competencies will be

reflected in .notices regarding the requirements of jobs to be filled. As the competency

profiles are completed, sample notices are developed for the varied types of jobs/ roles. .

Interview and Reference Checking Guides - Template interview and reference checking

guides are developed for varied types of jobs/ roles, including instructions and rating

guides. These are made available to hiring managers and HR Advisors.

Template Interview and Reference Checking Guides - Template interview and reference

checking guides are developed for roles/career streams and levels within Occupational

Groups including instructions and rating guides. These are made available to hiring

managers and HR Advisors.

Competency-based Track Record / Portfolio Reviews - Track record / portfolio reviews

allow employees / applicants to document their past experiences and accomplishments that

relate to the competency requirements for positions within the organization. Once

completed, trained evaluators score the extent to which the required competencies are

demonstrated in the written examples using standardized scoring criteria. Typically, the

candidate / employee also provides references who can attest to the validity of the

examples provided. Results can be used as part of the staffing process and / or for other

purposes (e.g., competency gap analysis for Learning and Development; Succession

Management; HR Planning).

Other Competency-based Assessment Methodologies - A variety of other competency-

based assessment methodologies can be incorporated into the selection process, including

21

In-basket assessments, role plays or simulations of workplace situations that the employee

will encounter, multi-source input (as appropriate), etc. When designing and implementing

any methodology, it is important that it be defensible (i.e., reliable, fair, valid and

unbiased).

Training on Competency-based Selection - Managers must have the knowledge and skills

to be able to apply the various competency-based assessment methodologies noted above

to arrive at valid selection decisions. Likewise, employees must be able to participate

effectively to provide an accurate picture of the competencies they possess. Finally, both

managers and HR professionals must be able to establish selection processes that are both

efficient and effective (i.e., reliable, fair, valid and unbiased). All of this requires targeted

training / orientation programs to ensure that all stakeholders have the necessary skills.

2.4 Competencies and changing perspectives on HRM

Baruch (1998) highlights the short-comings of traditional ‘hard’ approaches to HRM

where the emphasis is on making the best use of resources (including human resources)

and aligning Human Resource strategies with business plans. Baruch argues that this

approach to Human Resource Management uses and involves people as passive actors. By

contrast, the soft approach emphasises that people are one of the key factors involved in

whether or not an organisation can deliver, and that HRM must unleash the potential that

every individual can make to the organisation. Thus the soft approach emphasises people

as a valued asset, as proactive actors who can be trusted and who should be developed. It

emphasises participation and empowerment and expects that in return for truly

22

demonstrated leadership and commitment to people, people will demonstrate true

commitment and loyalty to the organisation. While the hard and soft approaches are not

mutually exclusive, Baruch suggests that it is the soft approach that has the potential to

provide the leverage to move organisations forward, to change-enable them and to provide

competitive advantage. In this light Horton (2000) suggests that competency-based

management represents a cultural change towards greater employee self-direction and

responsibility in the search for excellence rather than standard performance.

Hartle (1995) suggests that it is not just the organisation but also the individual who stands

to benefit from the competency-based approach. The organisation benefits from better

planning, better communications, improved managerial capabilities an empowered

workforce, focused development planning, better value for money, and improved

performance at all levels. Similarly the benefits for individuals can include clarity about

what they are required to do, better dialogue with managers and colleagues, better quality

management, feedback and support, more freedom to decide on the what and how of

performance, a structured framework for developing performance and potential, better

recognition for doing good work and an opportunity to meet expected performance in a

structured and consistent way.

Within competency-based HRM, Hondeghem and Vandermeulen (2000) suggest that there

are three possible roles for the HR function. The first is the customer service model, where

HR managers serve line managers as customers. The second is the organisational

development or consultancy model, where the HR officer functions as an internal

consultant to the line manager on a range of organisational issues. The third model is the

23

strategic HRM model, where HR managers act as full members of the strategic

management team, linking HR policy to agency mission, goals and policy.

2.5 An integrated approach to HRM – the role of competencies

The development of an effective competencies framework can provide opportunities for

individual and organisational growth and, in the longer term, can enhance the success of an

organisation. More specifically, when used effectively competency-based approaches can

act as a powerful development and motivational tool for staff.

Research carried out in the UK in 1994 ( Garavan et al, 1995) highlights a range of

motives for the introduction of competencies. Interestingly, while the most common reason

for the introduction of competencies was to improve performance, the numbers who did so

for recruitment and training and development purposes are also significant. In a study

carried out by the Hay Group ( HR Focus, 1996) of competency practices in 217

companies, it was found that ninety per cent of companies used competency-based

appraisal for employee development purposes, while eightyeight per cent used them to

make selection or hiring decisions. This study also showed that almost twenty five percent

of the companies surveyed had competency based pay systems in place. Research cited by

Pickett (1998) also highlights employee development and recruitment and selection needs

as common motives for the introduction of competencies. The potential role of

competencies in achieving an integrated approach has been highlighted by Klein (1996)-

Competencies align and integrate all HR systems if the behavioural standards of excellent

24

performers become the foundation for recruitment, selection, pay, performance

management, promotions and development.

Armstrong (1997) stresses that competencies lie at the heart of Human resource

Management since they are directly linked to a fundamental aim of strategic Human

Resource Management – to obtain and develop highly competent people who will readily

achieve their objectives and thus maximise their contribution to the attainment of the goals

of the enterprise. He suggests that a competence framework can provide an invaluable

basis for integrating key Human resource Management activities and achieving a coherent

approach to the management of employees.

Similarly, Mirabile (1997) argues that while competency models provide potentially

valuable information, they will be useless if they are not promoted using a coherent and

systematic implementation strategy, supported by appropriate structures and processes

including HR systems. For example, if identified competencies are not linked to the

performance management system, or if different criteria are used to select or promote

people, confused signals will be sent out to employees as to what really matters in terms of

behaviour and performance.

2.6 Methodologies for developing competencies

A literature review is the most commonly used starting point (McCracken et al., 2000;

Health Scotland, 2003; Shilton et al., 2003, 2005; Moloughney, 2006 and Melville et al.,

2006). A literature review will inform the researcher not only on the approaches used in

relation to developing the competencies but can also give important information on the

25

health promotion workforce and setting. This is important as countries with similar

systems can benefit from flaws highlighted or gaps identified in previous studies. In

addition, a literature review will add to the theory base and enhance the understanding and

knowledge of the field of competency development. Finally the information gathered from

the literature review can provide a focus and starting point and guide in the development

phase of similar projects.

An alternative is to carry out an information gathering exercise. The purpose of this is to

focus on what actually happens in practice. This activity can be carried using a number of

methods but involves some sort of consultation.This can also include observing or

interviewing or an exemplary practitioner to identify the actions, content and context

involved in their exemplary practice (Centre for Health Policy, 2008).Other initiatives

undertook surveys of a representative sample of practicing professionals to determine what

they actually do in practice as they did in Scotland and the US (Health Scotland, 2003,

Gilmore et al., 2005).

Mapping exercises have also been used (Meresman, 2004; Health Scotland, 2003) where

mapping the domains and competencies can help identify what is considered to be core in

other settings. Functional analysis is also used in developing competencies (Skills for

Health, 2001, 2004). Functional analysis can be used to try and explain a recurrent activity

or behaviour pattern in individuals or groups. It can seek to understand how a socio

cultural institution works in terms or its roles or tasks (Hempel, 2001). This process

involves identifying the core functions of a group or organisation. Then these functions are

used to form a map and then key tasks are identified. However, functional analysis has

26

been criticised as being overly reductionist because there is too much focus on task, and on

how tasks should be undertaken, to allow what has been described as the artistry of health

promotion (Mendoza, et al., 1994).

Consensus building using the Delphi technique is commonly used (Howatt et al., 2000;

Shilton et al., 2003, 2005; Hyndman, 2009). The Delphi method, is an attempt to obtain

expert opinion and information in a systematic manner where participants are polled

individually usually with a self-administered questionnaire (Fink et al., 1984). This is a

multi-stage process where each stage builds on the results of the previous stage The survey

is conducted over a few rounds and after each one, the results are elicited, analysed and

then reported back to the group. It is an iterative process with the aim of using expert

opinion to reach consensus. A Delphi is considered complete when there is a convergence

of opinion or when a point of diminishing returns is reached (Fink et al., 1984). The Delphi

technique, although frequently used, has been criticised as it is suggested that it reduces

competencies to a meaningless middle ground and that the political aspects of health

promotion can be lost in the move towards the centre (Mendoza, 1994).

All consultations whether they are Delphi, think tanks or focus groups, will use multiple

rounds of consultation to ensure the widest scope of feedback possible. The feedback from

the consultation process is then analysed and this is used to prepare a final draft of the

competencies which can then be disseminated and ratified. However, as Moloughney

(2006) states, competency set development is an iterative process and it may be necessary

to cycle through some of these steps a few times. Even when a final draft set is produced, it

is really only a working draft that will need to be periodically reviewed and revised as

27

experience with the competencies accumulates and the field itself evolves. It is generally

agreed in the literature that competencies are more likely to be seen as appropriate and

valid if they are developed from the bottom up with the close involvement of the

professionals who have to demonstrate competence on a daily basis in their work (Birt and

Foldspang, 2009). However, it can also be argued that, by basing competencies on practice

as described and defined by practitioners, what is reflected is not necessarily best or

evidence-based practice but rather what is commonly done (Battel-Kirk et al., 2009).

There are also limitations in using current practice (or what might be termed ‘past’ practice

given that the development of competencies is a slow process) as the basis for

competencies, particularly if they are to be used in future planning.( Prastacos et al 2005)

for example, indicates that, in the business environment, competencies are often backward-

looking and recommend the use of a forward-looking development model which takes

cognisance of the context and the current trends within which the organisation operates. A

strategic approach that looks to the future as well as current practice when developing

health promotion competencies (Shilton et al.2001) and the importance of grounding

competencies in current policy has also been highlighted (Health Scotland, 2003). For this

reason the development of agreed upon lists of competencies has to be the result of a

repeated and continuing process, characterised by interaction between the main

stakeholders across the academic, practice and policy areas. It is not a purely academic

exercise, neither for that matter a purely practical or political endeavour, accordingly it is

necessary to develop a strongly communicative culture, with consensus building processes

in focus (Birt and Foldspang, 2009).

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2.6 Criticisms on Competency Frameworks

The Chartered Institute of Personnel and Development in the UK (CIPD) includes the

following as the common criticisms of competency frameworks; they capture the past and

are therefore out of date, they cannot keep up to date with the fast changing world, they

were introduced to improve performance and they have not done so, they are unwieldy and

not user friendly- they create clones; everyone is expected to behave in the same way. The

publication while acknowledging the validity of these criticisms, also notes that they have

been levelled with justification mainly at frameworks produced using poor practice and

highlights the need for care and understanding when developing and implementing

competency frameworks.

A major criticism of the competency approach, particularly in relation to professional

practice, which has already been noted in relation to health promotion (Shilton, 2001) is

that it may be overly prescriptive and can, therefore, limit intuition, creativity and

innovation. For example, Talbot (2004) suggests that the competencies approach has a

tendency to limit the reflection, intuition, experience and higher order competence

necessary for expert, holistic or well developed practice. Talbot (2004) also argues that a

reductionist tendency, which focuses on tasks and outcomes inherent in the approach,

ignores the complex processes needed for professional practice.

Lester notes that this approach has been extensively criticised for weaknesses in its ability

to represent occupations which are characterised by a high degree of uncertainty,

unpredictability and discretion, and its tendency to atomise work roles rather than represent

29

them holistically (Lester, 1994). The competency approach has also been criticised as

being overly universalistic (Bolden and Gosling 2004; Mendoza et al.1994). There is

discussion in the literature of the fact that there can be an assumption that competencies

and standards are equally relevant to all practitioners in all settings and situations, an

assumption that is, it is suggested, obviously incorrect. This again has resonance for health

promotion, which is practiced at different levels, by people from different backgrounds and

in a wide variety of settings. The concept of equifinality (Berttalanffy, 1968), which argues

that there can be many different and valid origins for a given outcome, can be related to the

context of practice, meaning that many different behaviours on the part of the practitioner

may lead to competent outcomes.

This broader interpretation of competencies should inform both the development and the

implementation of competencies. The challenge of establishing competency frameworks,

therefore, includes addressing the complexity of practice in a manner which is meaningful

and clear while also leaving room for the many varied paths possible in successful practice.

There is a need, therefore, to consider how core competencies will be expressed to be

meaningful, useable, relevant and succinct. ‘”What is needed is a set of commonalities

underlying the actions, with the recognition that specific actions will and should vary

depending on the context of practice” (Miller et al., 2010). It is important when

considering the potentially negative aspects of the competency approach and the

difficulties in the development, implementation and revision process to view this in

balance with the many listed positive aspects of competencies which include ( Shilton et

al., 2001) usefulness as a shared/agreed language for defining boundaries of profession and

the tasks, skills and knowledge required for adequate practice, helpfulness in developing

30

programmes and projects, curriculum development and in recruitment and selection

,contribution to defining/defending discipline.

31

CHAPTER THREE

RESEARCH METHODOLOGY

3.1 Introduction

This chapter discusses the research methodology for the study including the research

design, target population and sample design. In addition, data collection instruments and

procedures as well as the data analysis are elaborated in this chapter.

3.1 Research Design

This study was descriptive in nature. This design is preferred because it permits

comparative analysis.

3.2 Target Population

The researcher targeted all registerd hospitals in Nairobi. According to Kenya Medical

Association directory (2012), there are 60 registered hospitals in Nairobi. The list of

hospitals is attached as Appendix II.

3.3 Sampling Design

A sample size of forty hospitals was selected .This number is well above the generally

accepted minimum of thirty. It is also large enough to give room for possible non response.

Simple random technique was used to select the sample. The selected sample is attached as

Appendix III.

32

3.4 Data Collection

Primary data was collected. This was used to address competency based recruitment and

selection practices. The questionnaire was divided into two parts A and B. Part A

addressed the respondent firms’ profiles while part B will capture data on competency

based recruitment. The questionnaire was administered to the officer in charge of the

human resource function at each hospital.

3.5 Data Analysis

Data collected from respondents was both quantitative and qualitative in nature.

Quantitative data will be analyzed using the descriptive statistics such as mean scores and

standard deviations. The findings were then presented using tables, pie charts, and bar

graphs for easier interpretation. On the other hand, qualitative data was analyzed using

content analysis. The qualitative information was used to interpret or better understand

quantitative findings.

33

CHAPTER FOUR

FINDINGS, ANALYSIS AND INTERPRETATION

4.1 Introduction

This chapter presents data analysis, findings, interpretation and presentation. Data was

analyzed using descriptive tools where frequencies, percentages were used to interpret the

findings. The purpose of this study was to determine competency based recruitment and

selection practices by registered hospitals in Nairobi County.

4.2 Demographic Data

Table 4.1: Distribution of respondents by gender

Frequency Percent

Male 22 57.9

Female 16 42.1

Total 38 100.1

As shown in Table 4.2, majority of the respondents (57.9 percent) were male while 42.1

percent were female. This implies that majority of the officers in charge of the Human

Resource Function were male.

34

Figure 4.1: Distribution of respondents by age bracket

Findings presented in Figure 4.1 show that a vast majority of the respondents (68.4

percent) were below 30 years, 26.3 percent were between 30-40 years while the remaining

2.6 percent and 2.6 percent were between 41-50 and over 50 years respectively. This

suggests that majority of the Human Resource Officers in registered hospitals in Nairobi

County are below the age of 30 years. This is good for hospital because this category of

people are young, energetic and flexible enough to cope with a fast paced working

environment that is typical of institutions of this nature..

35

4.3 Factors considered in recruiting new staff

Table 4.2: The extent to which various factors are considered in recruiting new staff

Factor Mean Standard deviation

A staff with strategic thought 3.7 0.7

Good understanding of Organisation 3.3 0.8

Innovative Person 3.9 0.8

Effective and fluent communication 4.3 1.1

Good customer focus and public relations 4.3 0.9

Leadership abilities 3.7 0.9

Ability for teamwork 4.1 0.8

Ability for time management 4.4 0.6

Regarding the extent to which various factors are considered in recruiting new employees,

the respondents said that good customer relations is an important factor to consider with a

mean of 4.3 out of 5 (see table 4.2). Effective and fluent communication together with

good customer focus and public relations are also considered as important with a mean of

4.3 each. Ability for teamwork is also not overlooked when recruiting new staff. It had a

mean of 4.1. The ability to be innovative attained a mean of 3.9.

Other factors considered include leadership abilities and having strategic thought. These

two factors are equally considered with a mean of 3.7. The findings implied that the most

important factor to be considered when undertaking competence based recruitment and

selection was the ability to manage time well. Proper time management is an important

36

factor to be considered in hospitals because it enables one meet set objectives within

stipulated time.

As Gough and price (2004) note, appropriate programmes based on the personal needs and

experiences of health managers can then be put in place to train managers to provide

leadership and to ensure a sustainable improvement in the work context of health workers,

and hence on the quality of care and health of the communities their organizations serve

(Gough and Price 2004).

4.4 Interpersonal relations

Table 4.3: Mean and standard deviation for the measures interpersonal relations

Mean

Standard

deviation

Demonstrates trust, sensitivity and mutual respect 4.2 0.7

Recognizes the contrubutions diversity brings to job

performance and creativity 3.9 0.7

Demonstrates altruistic empathy 4.1 0.9

As shown in Table 4.3, majority of the respondents felt that a new recruit who

demonstrated trust, sensitivity and mutual respect was great. It had mean of 4.2 out of 5

while the competency aspect related to diversity in job performance had a mean of 4.1,

which is relatively high. The use of altruistic empathy scored a mean of 4.1. That

registered hospitals in Nairobi have embraced this aspect of interpersonal relations.

Frequent disagreements and lack for respect to one another by workers, especially those

within the same department bring about inefficiency which in turn threatens the very

37

survival of the organization. Hamel and Prahalad (1990) defined core competence as the

collective learning in the organisation, especially how to co-ordinate diverse production

skills and integrate multiple streams of technologies.

4.5 Self-awareness/ confidence

Table 4.4: Mean score and standard deviation for measure of self-awareness/

confidence

Mean Standard deviation

Accurate knowledge of his weakness 3.6 0.8

Self confidence 3.9 0.7

The findings presented in Table 4.4 show that that the respondents rated self-confidence

for new recruits (mean = 3.9) not as highly as other competencies. In addition to that, the

respondents scored the competence related to the new hire recognizing their own

weaknesses at a mean of 3.6. This corresponds to the fourth point on the scale. This was

lower than the mean for self-confidence (mean = 3.9). This was an interesting result

because Self-confidence is so crucial especially in a hospital set up due to the fact that it is

a life saving institution that requires minimum error and efficacy at all times,. Knowing

one’s weaknesses is also of significant importance because it will prevent failures

attributed to venturing into things which one is not well conversant with. Cockerill (1989)

combines output competences, like presentation skills, with inputs like self-confidence.

38

4.6 Analytical thinking

Table 4.5: Mean and standard deviaitions for the measure of analytical thinking


Information gathering skills 3.7 0.6

Use of range of resources 3.4 0.6

Looking beyond routinely explanations of organizational

performance 3.7 0.8

Good in decisionmaking 4.4 0.9

The researcher was also concerned with whether the respondents applied analytical

thinking in their work. The results are presented in Table 4.5, majority of the respondents

felt like the competence aspect related to good decision making was of most importance to

them in the recruitment and selection process and scored a high mean of 4.4. The

respondents also felt that when undertaking the recruiting and selection of staff the

competences related to the ability to collect and gather information in relation to the

respective departments was a consideration. This had a mean of 3.7. However this was

relatively lower than the competence related to decision making (mean = 4.4). In addition

to that, the respondents gave a fair amount of consideration to a new hire who had the

ability to think outside the box and use multiple sources when undertaking their work

roles. This aspect of analytical thinking had given a mean of 3.7. The above tabulation

shows that the most highly valued aspect of analytical thinking considered by the Human

Resource Officers from registered hospitals in Nairobi County when undertaking their

recruitment and selection of staff was a candidate who had the skills and ability to make

39

sound decisions in their work duties. The ability to make good and independent decisions

is important especially in a hospital environment.

4.7 Adaptability/flexibility

Table 4.6: Mean scores and standard deviations for measures of

adaptability/flexibility


Ability to adapt to styles and shift gears 3.8 0.8

Shows evidence of coping skills 3.9 0.8

Comfortable with new ideas and open to new information 4.1 1.0

Findings on adaptability and flexibility showed that many respondents were keen on

recruiting individuals who demonstrated the ability to bring new ideas and readily accept

changes that occur within organizations. As indicated in Table 4.7, innovative individuals

were considered as valuable assets to their institutions and they gave a high mean of 4.1.

The respondents also indicated that an individual who demonstorates that they are able to

cope with their work load,work times and their peers in general was something they were

on the look out for in the recruitment and selection process and gave. This measure

received a score of 3.9..

40

4.8 Observation skills

Table 4.7: Mean scores and standard deviations for measures of observation skills


Recognition of inconsistencies 3.7 0.6

Factual description 3.7 0.8

Accurate observation 4.0 0.9

Under this section of observation skills, the ability for a potential candidate to have

accurate observations was considered of utmost importance as shown by a mean score of

4.0. The officers in charge of the Human Resource function felt that an institution such as

theirs required individuals who were capable of giving correct information and would

consider that competence first. However, an individual who demonstrated that they could

readily identify inconsistencies in their work environment as well as retain information

well enough to give factual descriptions was something they placed great importance on

and this was given a mean score of 3.7. An individual who also had the skills and abilities

to observe and identify key elements in the work situation was also something that they

would look into in the recruitment and selection process and this scored a mean of 3.7.

4.9 Sense of mission

Table 4.8: Mean scores and standard deviations for measures of sense of mission


Adequate knowledge on the organization 3.5 1.0

Desire to make things better for others 3.9 0.7

41

The results from the findings in Table 4.1 show that the Human Resource Officers were

flexible when it came to a potential hire that may not have adequate knowledge of the

organization because they could learn more about the organization once they were

recruited. Because of this they gave a mean score of 3.5. However they felt that a potential

new hire who not only wanted to improve their own performance but also wanted to

improve performance of their workmates and thus improving the performance of the

institution as a whole, was one they would consider greatly in the recruitment and selection

process. This was given a mean score of 3.9.

4.10 Communication skills

Table 4.9: Mean scores and standard deviations for measures of communication skills


Speaks clearly and expresses self well 4.1 0.9

Demonstrates attentive listening 4.0 0.9

Conveys information 3.9 1.0

Communication is one of the aspects that is critical in many organizations especially the

service industry. As depicted in Table 4.9, the respondents felt that an individual who

demonstrates the ability to speak well and clearly was of utmost importance to them and

gave a high mean score of 4.1. However, all aspects of communication were also

considered important when looking for a new recruit and consequently high mean scores

were given to individuals who were good listeners and who were able to convey

information efficiently and effectively. The mean scores given were 4.0 and 3.9

respectively. This goes to show that the respondents felt that a potential new hire who had

42

good communication skills would be greatly considered and have an edge over other

potential candidates.

4.11 Motivation

Table 4.10: Mean scores and standard deviations for measures of motivation


Commitment to organizational goals 4.2 0.8

Strive to achieve/improve 4.2 0.7

Sets high standards of performance 4.1 0.7

Disaplay high level of effort and commitment

towards performing the work 4.1 0.8

Optimism/ persistence in pursuing goals 4.2 0.8

It is clear from the results in Table 4.9 that the respondents in the various hospitals felt that

whenever they were undertaking the recruitment and selection exercise, they would be

looking for an individual who was highly motivated. They scored all aspects of motivation

generously. An individual who was committed to their institutions, who was result driven

and constantly wanted to improve was someone who they were keen to recruit and they

gave a mean score of 4.2. In addition, the respondents also felt that an individual who set

high standards of performance in their work roles and displayed commitment in their work

duties- be it working overtime or doing the job right the first time would be considered a

good fit for their institutions and gave a high score of 4.1. Commitment, persistence and

desire to achieve are very important inputs to any organization. If the organization gets to a

level where everyone is committed and moves ahead with persistence this will make

achievement of set goals and objectives easier. Hartle argues that competency is a

43

characteristic of an individual that has been shown to drive superior job performance

(1995) includes both visible competencies of knowledge and skills and underlying

elements of competencies like traits and motives.

4.12 Planning and organizing work

Table 4.11: Mean scores and standard deviations for measures of planning and

organizing work


Ability to reprioritize/Assess 4.0 0.8

Defines and arranges activities in a logical and efficient manner 4.0 0.8

The results from the findings in Table 4.11 indicate that the officers in charge of the human

resource function also felt that an individual who demonstrated strong skills of planning

and organization would be considered highly in the recruitment and selection process.

They would consider individuals who had the ability to prioritize their work activities.

They were looking for recruits who knew which work activity to consider as important and

also have a work plan so that there would be no consequent delays. They also looked for

potential candidates who had aspects of precision processing therefore could act in a

logical as well as efficient manner and they gave a mean score of 4.0.. The ability to

reprioritize work is important because sometimes n there can be situations of emergency or

change which may disrupt the initial work plan. In addition to that, there is a need to

arrange activities in a logical and efficient manner. This facilitates effective and easier

achievement of set goals and objectives.

44

4.13 Teamwork

Table 4.12: Mean scores and standard deviations for measures of teamwork


Contributes to organizational goals 4.3 0.6

Fosters collaboration among team members as part of teamwork 3.9 0.8

The researcher also wanted to find out whether teamwork contributed to organizational

goals. The findings in Table 4.12 confirmed that the virtue of teamwork did contribute to

organizational goals. This had a mean score of 4.3 with respects to individuals who were

willing to contribute their current skills and abilities for the improvement of the institutions

goals and objectives. At the same time, collaboration among team members as part of

teamwork was expressed as imperative for a fully employment of competency based

recruitment and selection with mean of 3.9. The respondents further reiterated that when

conducting the recruitment and selection process they would be looking for a potential

recruit who apart from utilizing their skills to contribute to organizational goals, would be

able to work well with their peers through good relations and collaboration. The

respondents gave a mean score of 4.3. This high score indicates that the Human Resource

personnel in hospitals in Nairobi county value individuals who display these kind of

competencies in order for the institutions to run smoothly. Mullins (2010) notes that the

HRM function is to remain effective; there must be consistently good levels of teamwork,

plus ongoing co-operation and consultation between line managers and the HR manager.

45

CHAPTER FIVE

SUMMARY, DISCUSSION, CONCLUSIONS AND

RECOMMENDATIONS

5.1 Introduction

This chapter presents the summary of findings, conclusions and recommendations. The

chapter also give suggestions for further studies

5.2 Summary of findings

This study used descriptive survey to investigate competency based recruitment practices

by registered hospitals in Nairobi.. The target respondents were selected registered

hospitals in Nairobi County. Majority of the respondents (57.89 percent) were male while

42.12 percent were female.

Findings on the age of respondents showed that a vast majority of the respondents (68.4

percent) were below 30 years, 26.3 percent were between 30-40 years while the rest2.6 and

2.6 percent were between 41-50 and over 50 years respectively

Regarding the extent to which various factors are considered in recruiting new members,

the respondents said that good customer relations is an important factor to consider with a

mean of 4.4. Effective and fluent communication together with good customer focus and

public relations are also importantly considered with a mean of 4.3 each. Ability for

teamwork is not also overlooked when recruiting new members. It is considered with a

mean of 4.3. A person who is innovative is also taken into consideration with a mean of

46

3.9. Other factors considered include leadership abilities and having a strategic thought.

These two factors are equally considered with a mean of 3.7.The findings also indicated

that having a good understanding of the organization was also a consideration when

recruiting new members.

Concerning interpersonal relations, majority of the respondents demonstrated trust,

sensitivity and mutual respect with a mean of 4.2 while others recognized the contributions

diversity brings to job performance and creativity with a mean of 4.1, At the same time,

some respondents demonstrated altruistic empathy. On whether the respondents have self-

awareness and confidence, it was evident from the findings that many respondents

considered self-confidence as an important factor in the recruitment and selection process

and gave a mean of 3.9. In addition to that, they were looking for an individual who had

accurate knowledge of their weaknesses but was not deemed as important as some of the

other competencies and thus gave a mean score of 3.6 With regard to whether the

respondents were looking for an individual who applied analytical thinking in their work,

the aspect of a potential hire who had good decision making skills scored the highest with

a mean score of 4.4.However individuals who displayed characteristics of having the

ability to gather information systematically and have vision were also given relatively

good mean scores of 3.7.

Findings on competency aspects of tadaptability and flexibility showed that many

respondents were comfortable with potential candidates who were willing to bring in new

ideas and who were open to new information or changes that come up in the work

situation. For example introduction of Information technology systems that could improve

47

the work situation in order to achieve organizational goals. The mean score was a

favourable 4.1..In addition the respondents emphasizedthe importance of looking for an

individual who had good coping skills.This was considered in the recruitment and selection

process and the mean score awarded for this was a4.0. Concerning competencies related to

observation skills, majority of the respondents said that they put great consideration for a

potential new hire who had a strong command of accuracy and this was given a high score

of 4.0.In addition a potential hire was also required to exhibit skills relation to identifying

inconsistencies as well as being able to be factual at all times. They gave a mean score for

3.7 for the two.

The researcher also wanted to know whether there was a sense of mission among the

respondents. From the findings, majority of the respondents indicated that in their

recruitment and selection process they were looking for individuals who possessed the

desire to make things better for others with whom they were working with and not just

their own individual progress in the organization. This was a necessity because in order for

the organization to improve and meet its said objectives growth was required at the

individual level as well as the organizational level.. The respondent also indicated that they

were looking for individuals with good communication skills. The service industry heavily

relies on its human resource to keep the organization running.

Hence having employees with good communication skills was of paramount importance to

them.Emphasis was placed on recruiting individuals who had the ability to express

themselves well, were good listeners and could convey information to the recipients

efficiently and effectively. The mean scores had highs of 4.1. The respondents were also

48

looking for individuals who were highly motivated and this also included self motivation.

A hospital, being a 24 hour institution has long working hours midnight shifts as well as

patients coming with different levels of sickness from minor to major hence they would

always look for a potential candidate who would be able to motivate themselves under

such working conditions. The respondents gave a mean score of 4.2 for all the

characteristics that entail motivation. These include commitment to the hospital, result

driven, and perseverance among other characteristics. There was also great emphasis in the

recruitment and selection process for looking for an individual who had good planning and

organizing skills. They were looking for individuals who knew how to use tools of

management for the betterment of the organization to speed up their work duties in an

effective manner. They also wanted individuals who were able to prioritize their specific

workloads to maximize on efficiency and who did this in a logical and systematic manner.

They gave a mean score of 4.0.

The researcher also wanted to find whether teamwork contributed to organizational goals

and respondents confirmed that teamwork contributed to organizational goals because

hospitals operate in a time sensitive environment and all employees need to work well

together because all departments heavily rely on each other to ensure that patients have the

best care and attention and have a smooth transition from point of entry with the nurse,

then the doctor and payment section. This had a mean score of 4.3

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5.3 Conclusions

This study was carried out with the objective of determining the competency based

recruitment and selection practices adopted by registered hospitals in Nairobi. It can be

concluded that the results from the findings of the questionaire demonstrated that

competency based recruitment procedures were paramount in selecting new hires. The

respondents recognized that competency based recruitment procedures can work hand in

hand with traditional recruitment and selection procedures. The competency based

approach to recruitment and selection was considered important in the recruitment and

selection stage of Human Resource Management processes.

The research also found that adopting a competency based recruitment and selection

system is a results oriented process. It makes it easier to concentrate on the results expected

of a successful or exemplary performer (Guinn, 1998). In addition the competency based

recruitment and selection technique gave the recruitment staff the opportunity to focus less

attention on approximations of competence such as educational level or years of

experience that have little connection to verifiable results. Also competency-based

recruitment plays an important role in attracting individuals who possess characteristics

that might be difficult, if not impossible, to acquire by training or development efforts. A

competency based approach encourages managers and other decision makers to clarify the

verifiable, measurable results they expect from successful performers before a selection

decision is made.

Competency-based selection, according to the respondents provides some insight into

whether or not a new hire will be a good fit with the institutions culture. A competency-

50

based recruitment and selection process provides applicants with opportunities to outline,

explain, and demonstrate their qualifications in competency-based terms. Potential

candidates will not be confronted during the selection process with questions that have

little or no bearing on their ability to produce desired work results

From the findings, it was noted that competencies predict effective performance, result in

valid selection criteria, recognize the transferability of employees' skills and are flexible to

meet the changing needs of future requirements. Furthermore, the competency model

covers all aspects of what it takes to be successful in a job by examining not only

knowledge and skills required but the personal attributes required as well.

5.4 Recommendation

The recruitment and selection process is one of the most important and costly investments

an organization can make. Risks can be high and the cost of a bad hire can have

tremendous impact in time, money and company culture.

In addition to the above discussed and detailed conclusions, the following

recommendations should be taken into consideration by hospitals in their competency

based recruitment and selection

Need to develop and implement a communication strategy to support the Human

Resource Departments

51

Building awareness is an important starting point. HR staff and hospital

management should attend workshops, classes, or conferences on competency

modelling or invite external consultants.

The management of the hospitals need to provide time and money to carry out the

individualized competency identification and assessment for those targeted to

receive training.

The management of the hospitals should provide strong, long-term support for the

projects and act as role models for the process. Required resources need to be

available over the long term. Managers will face increased workloads as a

competency-based approach requires them to provide new hires with additional

and more effective feedback as well as accept responsibilities for addressing

performance obstacles.

The Human Resource Department must continuously evaluate the competency

based recruitment and selection process and make revisions as necessary

5.5 Suggestions for further studies

While this study was able to provide additional insight into the use of competencies and its

relationship to an effective recruitment and selection process in hospitals, it also revealed

areas that would benefit from further research. These are:

Future research could thus focus on the other functions such as compensation and benefits.

By doing so, a better and fuller understanding of the effects of core competencies on an

organization’s performance may be achieved.

52

Secondly, this study recognized the importance of measuring the performance of the

hospitals’ employees according to their core competencies, hence, there is a need for

further study on the benefits of the competency based performance management systems.

53

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Chapter 5 takes a themed approach to the topic of employee selection.

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APPENDICES

Appendix I: Questionnaire

This questionnaire is designed to gather information on Competence Based Recruitment and Selection. The information you give will be treated with utmost confidentiality and will be solely used for academic purposes intended in this research. Please tick where appropriate next to the response you deem necessary or fill in the required information. Please respond to all the items.

PART A: PROFILE OF THE FIRM/RESPONDENT

1) Indicate your gender?

a) Male [ ] b) Female [ ]

2) Indicate your designation/position in the institution? _____________________________

3) Indicate your age bracket a) Below 30 years [ ]

b) 30-40 years [ ]

c) 41-50 years [ ]

d) Over 50 years [ ]

PART B: COMPETENCY BASED RECRUITMENT

4) When recruiting new members of staff, to what extent do you consider the following aspects?

Aspect Not at all

Little extent

Moderate extent

Large extent

Very large extent

a) Good understanding of your organization

b) A person with strategic thought

c) Innovative person d) Able to communicate

fluently and effectively e) Good customer focus and

able to relate well with the

57

public f) leadership abilities g) Ability to teamwork h) Ability to manage time

well i) Any other (specify)

On a scale of 1 to 5 where 1 represents the least extent while 5 gives the greatest

extent, indicate the level to which you consider the following factors when you are

recruiting.

1 2 3 4 5

5) Interpersonal Relations: Awareness of others’ feelings, needs, perceptions and concerns

a) Relates well to others

b) Demonstrates trust, sensitivity and mutual respect

c) Recognizes the contributions diversity brings to job performance and creativity

d) Demonstrates altruistic empathy – caring for others

6) Self Awareness/Confidence: Knowing one’s internal states, preferences, resources and limitations

a) Accurate knowledge of his/her weaknesses

b) Self-confidence: strong sense of self worth and capabilities (self efficacy)

7) Analytic Thinking: Using data to understand patterns and develop concepts

a) Information gathering skills

b) Use of range of sources

c) Looking beyond routinely explanations of organizational performance

58

d) Good in decision making

8) Adaptability: Flexibility in handling change

a) Handles day-to-day challenges confidently

b) Is willing to adjust to multiple demands, shift priorities, ambiguity and rapid change depending on organizational demands

c) Shows resilience in the face of constraints, frustrations or adversity

d) Ability to adapt styles and shift gears

e) Shows evidence of coping skills

f) Innovation: comfortable with new ideas; open to new information.

9) Observation Skills: Ability to describe events factually

a) Ability to observe and identify key elements

b) Recognition of inconsistencies

c) Factual descriptions

d) Accurate observations

10) Sense of mission: Commitment to the achievement of the organizational objectives

a) Evidence of adequate knowledge on the organization

b) Desire to make things better for others

11) Communication Skills: Open clear communication

a) Speaks clearly and expresses self well

b) Demonstrates attentive listening

c) Conveys information clearly and effectively through

59

written documents

12) Motivation: Emotional tendencies that guide or facilitate reaching organizational goals

a) Commitment: aligning with the goals of the organizational

b) Achievement: strives to improve, drives for results and success

c) Sets high standards of performance

d) Displays a high level of effort and commitment to perseverance performing the work

e) Optimism: persistence in pursuing goals

13) Planning and organizing work: Ordering activities to achieve goals

a) Ability to assess/reprioritize

b) Use of time management tools

c) Defines and arranges activities in a logical and efficient manner

14) Teamwork: Creating group synergy in pursuing collective goals

a) Contributes to organizational goals

b) Fosters collaboration among team members and among teams

15) Any other comments ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

THANK YOU FOR YOUR COOPERATION

60

Appendix II: List of Hospitals

Name Location 1) Aga Khan Hospital Parklands 2) Alpha Maternity & Nursing Home Eastleigh 3) Avenue Hospital Parklands 4) Central Park Hospital Kibera 5) Chiromo Lane Med Centre Westlands 6) City Nursing Home Mufungano Street 7) City Park Hospital Park Road 8) Comprehensive Medical Services Thetha Road off Lenana Road 9) Coptic Church Nursing Home Ngong Road 10) Dorkcare Nursing home Munyu Road 11) Eastleigh Community Clinic 5th street, Eastleigh 12) Emmaus Innercare Nursing Home Umoja Inner core 13) Genisis Nursing & Maternity Hospital 14) Getrude Garden Childrens Hospital Muthaiga 15) Guru Nanak ramgarhia Sikh Hospital Murang’a Road 16) Huruma Nursing Home Huruma estate 17) Ideal Nursing Home Juja Road 18) Inder Nursing Home Pangani 19) Jamaa Home & maternity Hospital Rabai Road, Uhuru Estate 20) Kabiro Health care Trust Kawangware 46 21) Kasarani Maternity & Nursing Home Kasarani 22) Kayole Hospital Ltd Kayole 23) Kilimanjaro Nursing Home Eastleigh Section 1 24) Komarok Nursing Home Komarock 25) Lions Sightfirst Eye Hospital Loresho 26) M. P Shah Hospital Parklands 27) Mara Maternity & Nursing Home Kayole Estate 28) Madina Nursing Home 9 th street Eastleigh 29) Kenyatta Hospital Private Wing KNH 30) Karen Hospital Karen 31) Family Health Care Off Langata Road 32) Maria Immaculate Mission Hospital Gitanga Road 33) Mariakani Cottage Hospital South B 34) Masaba Hospital Adams Arcade 35) The Mater Hospital South B 36) Melchizedek Hospital Naivasha Road 37) Metropolitan Hospital Rabai Road 38) Mother & Child Hospital Eastleigh Sec vii 39) Nairobi Equator Hospital Nairobi West

61

40) The Nairobi Hospice Next to KNH 41) The Nairobi Hospital Argwings Kodhek Road 42) Nairobi Women’s Hospital Nairobi west 43) Nairobi West Hospital Hurlingham 44) Ngara Nursing Home Ngara 45) Lianas Hospital Kangemi 46) The Olive Tree Hospital South C 47) Kijabe Mission Hospital Kijabe 48) Kikuyu Mission Hospital Kikuyu 49) Park Road Nursing Home Park Road 50) Parklands ambulatory Surgical Centre Parklnads 51) Prime Care Hospital Tena estate 52) Redient Health Nursing home Pangani 53) Right Medical Centre Lavington 54) St. James Hospital Mombasa Road 55) St. James Medical Centre Ltd Komarock Road 56) St. Marys’ Mission Hospital Otiende 57) Samar Clinic & Maternity Home Kahawa Sukari 58) South B Nursing Home South B 59) Umoja Nursing Home Umoja Phase 1 60) Westlands Cottage Hospital East Church Road

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Appendix III: List of Sampled Hospitals

Name Location 1) Aga Khan Hospital Parklands 2) Alpha Maternity & Nursing Home Eastleigh 3) Central Park Hospital Kibera 4) Chiromo Lane Med Centre Westlands 5) City Park Hospital Park Road 6) Comprehensive Medical Services Thetha Road off Lenana Road 7) Dorkcare Nursing home Munyu Road 8) Eastleigh Community Clinic 5th street, Eastleigh 9) Genisis Nursing & Maternity Hospital 10) Getrude Garden Childrens Hospital Muthaiga 11) Huruma Nursing Home Huruma estate 12) Ideal Nursing Home Juja Road 13) Jamaa Home & maternity Hospital Rabai Road, Uhuru Estate 14) Kabiro Health care Trust Kawangware 46 15) Kayole Hospital Ltd Kayole 16) Kilimanjaro Nursing Home Eastleigh Section 1 17) Lions Sightfirst Eye Hospital Loresho 18) M. P Shah Hospital Parklands 19) Madina Nursing Home 9 th street Eastleigh 20) Kenyatta Hospital Private Wing KNH 21) Family Health Care Off Langata Road 22) Maria Immaculate Mission Hospital Gitanga Road 23) Masaba Hospital Adams Arcade 24) The Mater Hospital South B 25) Metropolitan Hospital Rabai Road 26) Mother & Child Hospital Eastleigh Sec vii 27) The Nairobi Hospice Next to KNH 28) The Nairobi Hospital Argwings Kodhek Road 29) Nairobi West Hospital Hurlingham 30) Ngara Nursing Home Ngara 31) The Olive Tree Hospital South C 32) Kijabe Mission Hospital Kijabe 33) Park Road Nursing Home Park Road 34) Parklands ambulatory Surgical Centre Parklnads 35) Redient Health Nursing home Pangani 36) Right Medical Centre Lavington 37) St. James Medical Centre Ltd Komarock Road 38) Samar Clinic & Maternity Home Kahawa Sukari 39) South B Nursing Home South B

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40) Umoja Nursing Home Umoja Phase 1

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